Journal of Medical Council of Iran
Year:2001 | Volume:19 | Issue:3|Papers Count:13

In the diagnosis of meningitis, CSF studies are of importance such as estimation of CSF glucose concentration. This factor , along with simultaneous blood glucose concentration are determined and made use of in assessin" meningitis. Due to the nonavailability of the means to obtain a blood sample for glucose and CSF concomittantiy in some cases, in order to prove the difference, we decided to obtain blood glucose before or after the lumbar puncture and conduct a research to determine whether a blood glucose noncomittantly with the lumbar puncture was of value or not. Over 15 months, we conducted our study at Imam Reza Pediatric emergency room on 50 children with possible meningitis. We obtained three samples of blood (45 minutes before, at the time of Lp and 45 minutes after LP) and one sample of CSF from each child for glucose concentration and determined by spectrophotometry. Then we analysed our data with two ways. First with the paired samples t. test we evaluated the results and it was proved that there weren t any significant differences between blood glucose before, simultaneously and after LP thus concluding that blood samples obtained at intervals of 45 minutes difference compared to the CSF specimens could of value in assessment. Secondly we determined the percentage of meningitis with the CSF/ blood glucose ratio.Values of 40% (for bacterial meningtis) and 66% (for aseptic meningtis) were of clinical importance.

Since typhoid fever is one of the most common infectious diseases in our country particularly in the western provinces such as Kermanshah; and the Widai test being one of the most common serologic tests ordered by physicians, thus to evaluate the diagnostic usefulness of this diagnostic tool we undertook a retrospective case control study in 144 patients with blood or bonemarrow culture positive for salmonella typhi (as cases) and144 patients with brucellosis with a Widal test in their hospital files (as controls).48% of our patients were female, 52% male and 91% less than 35 years old. The Widal test was negative in 60% of cases and 94% of controls (0 titer of 1:40 or more).The sensitivity of this test in a titer of 1:80 was 38% (less than many other studies) and its specificity was 96% (similar to other studies) and we concluded that a negative Widal test would not exclude the diagnosis of typhoid fever, but a positive Widal test could be highly suggestive of typhoid. Despite its limitations the Widal test remains a valuable and highly specific tool for rapid diagnosis of typhoid fever.

Although minor systematic variations between the results of blood gas analyzers are inevitable; they seem not to have any adverse clinical effect due to their being trivial. In this study we tried to show the clinical significance of these minor systematic variations.Sixty-eight patients in Shariati Hospital were studied. Their arterial blood samples were analyzed simultaneously by two blood gas analyzers available at Shariati Hospital and the results were compared. The mean of differences for pH, P02 and Pea2 were respectively 0.051, 1.122 and 2.734 mm Hg. The differences of pH and Pc02 were significantly different from zero (P =0.000001). The clinical study showed 9% discrepancies in diagnoses of respiratory disorders and 26.5% discrepancies in diagnoses of acid base disorders. All the respiratory disorder discrepancies were located in the range of 58-90 mm Hg for P02 (p =0.013). And the majority of acid base discrepancies were located in a special range of pH (7.306-7.466) and Pea2 (25.6-39.1) (P=0.000005).This study proved that minor systematic errors in blood gas analyzers could affect clinical judgement specially if the results are found to be in a particular range are clinically significant.

This is a Quasi-experimental research, that has been carried out, in order to, evaluate, "The effect of Paced respiration and muscular relaxation techniques on vasomotor symptoms in the menopausal women," referred to a selected hospital of Tehran University of Medical Sciences.Subjects (patients) were 90 menopausal women 45-60 years old, with at least 2-3 hot flushes per day, who were divided into 3 equal groups: A: Paced respiration groupB: Combined relaxation (progressive muscular relaxation and paced relaxation)C: Control groupAfter teaching paced and relaxation procedures to the subjects in 5-6 sessions and practicing, treatment procedures in 5-6 sessions and practicing, treatment procedures were performed in 15-20 minute periods, twice or more times a day, for ten days (every other day).After collecting data from treated and control groups by questionnaire on the 20th day, Results were analysed and compared before and after treatment by descriptive analysis and analytical tests, such as, Chi square, Fisher, T test, T student and variance analysis.We concluded that, "Frequency and intensity of hat flushes and other vasomotor symptoms in treated groups were significantly reduced (P <0.01)."

Cerebral palsy (CP) children because of lack of power in controlling and integrating their movements need help and assistance for their correction. In order to overcome such limitations and since cerebral palsy children need the basic movements for carrying out and integrating forming and their walking movements, and for the systematic arrangement of these movements, we could design and manufacutre a special machine which meets the basic needs of CP patients to a considerable scale.To gain access to the most suitable measurements and the distances which are created, while the children are creeping, 200 children refering to five training and medical centers were studied and experimented and with the coordination of the research Undersecrtary of the Ministry of Health and Medical Education, an Auto Creeping machine was designed and manufactured after results of about two years constant works and tests.

Despite adequate sunny days in Iran, vitamin D deficiency, rickets and osteomalacia are still common health problems in the region. While 25 hydroxyvitamin D (25-0H-D) is the most abundant metabolite of the hormone and its blood cocentration reflects the total body stores of the substance, 172 blood samples from normal Iranian males and females between 20-45 years old were analysed.The mean values for the men was 23.9 ng/ml and for the women was much smaller, 16.3 ng/ml, P<0.001. 26.7% of the subjects had 25-0H-D levels less than 10 ng/ml and 27.3% had values between 10-20 ng/ml. While values less than 10 ng/ml reflect sever deficiency and values between 10-20 ng/ml reflect mild to moderate deficiency, we can conclude that more than 50% of the study group suffered from mild to severe vitamin D deficiency.This deficiency is due to the lack of the substance in most foodstuffs and lack of sun exposure due to traditional clothings. Serum parathormone leveis were within normal limits and no correlation could be found between the two variabls. While vitamin D is essential for bone health specially in children, forticification of milk with vitamin D is highly recommended in lactating and pregnant women and also the elderly people.

Visual disturbances were studied in a national sample of 59678 people (1/1000 of country population) through self-reporting of visual disturbances, and through measurement of visual acuity and visual field by optometrists in 1/3 of the same sample who were 5 years old or more. The national survey has been undertaken in 1994. It has been designed by Welfare and Rehabilitation University of Iran, and conducted by Welfare Central Offices in each state, through cluster sampling method (cluster of 15 dwellings).The results show that 32.3% of the country population has a visual acuity of equal or less than 20/30 in at least one eye and 23.1% for concurrence in both eyes. Estimate of partial prevalence of visual disturbance(visual acuity equal or less than 20/30 in both eyes) in all states with respect to Tehran prevalence implies that prevalence of 7 states statistically is higher and of 10 states is less than prevalence of Tehran state (P<0.05).Prevalence of visual field disturbance is 6.3% in both eyes and 9.1 % in at least one eye. Estimate of partial prevalence of this visual disturbance with respect to prevalence of Tehran state shows that prevalence of 9 states statistically is higher and of 1 state is less than prevalence of Tehran state (P< 0.05). Difference in visual disturbances in states could be from different epidemiological patterns ,diffrent rates and quality of health services in states.Aging causes the visual disturbances increase, based on both visual acuity and visual field data.

It is a rare disease with a peak incidence between 40-80 years. 17 cases have been reported under the age of 12 years. Usually it is seen in the cervico - thoracic region, and in 99%. It is found at the posterior epidural region. Surgery is indicated in most of the cases. In this report two cases aged 11 and 14 are reported. With epidural hematoma located anterioly and in one case located posterloriy. Two of the cases were managed medically and one underwent surgery.

Bleeding symptoms are one of the most common problems affecting millions of people and facing physicians in all parts of medicine.Not every bleeding is pathologic. The line of demarcation between the so-called "normal bleeding" and abnormal one is not clear and depends upon the general in formation of the physician.Abnormal bleeding can be due to defects in the vascular system, plateletes number or function, coagulation factors and inhibitors, abnormal fibrinolysis, or a combination of these factors. A knowledge about abnormal bleeding and its correct tackling is essential for all medical personnel. A wrong execution and analysis of coagulation tests could cause confusion, anxiety and wrong diagnosis and entail both tinie and expenses.In this article, a compact review of hemostasis and coagulation mechanisms is presented, coagulation tests are reviewed, and interpretation of abnormal clinical and laboratory findings discussed.With regard to relative insensitivity of routine laboratory screening coagulation tests, a through personal and family history of bleeding problems is always essential and makes the cornerstone for interpreting the abnormal (and even normal) results. If the history is not supportive of coagulation disorders, analysis of the tests should be performed with caution.